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Preoperative localization in unilateral parathyroid surgery. A cost-benefit study on ultrasound, computed tomography and scintigraphy

Udén, P LU ; Aspelin, P; Berglund, J; Lilja, B; Nyman, U LU ; Olsson, L E LU and Zederfeldt, B (1990) In Acta Chirurgica Scandinavica 156(1). p.29-35
Abstract

In 50 patients with primary hyperparathyroidism, investigation before initial neck exploration included ultrasonography, computed tomography and 99technetium-201thallium subtraction scintigraphy. The sensitivity for correct preoperative localization was 50%, 54% and 56%, respectively. There was marked inter-observer variation in assessment of ultrasonography and computed tomography, while scintigrams were evaluated by only one person. The scintigraphic sensitivity increased with size of the glands. In cases where correct preoperative localization permitted unilateral parathyroidectomy, the time for surgery and anesthesia was significantly reduced. A cost-benefit analysis, however, revealed that the financial saving from this time... (More)

In 50 patients with primary hyperparathyroidism, investigation before initial neck exploration included ultrasonography, computed tomography and 99technetium-201thallium subtraction scintigraphy. The sensitivity for correct preoperative localization was 50%, 54% and 56%, respectively. There was marked inter-observer variation in assessment of ultrasonography and computed tomography, while scintigrams were evaluated by only one person. The scintigraphic sensitivity increased with size of the glands. In cases where correct preoperative localization permitted unilateral parathyroidectomy, the time for surgery and anesthesia was significantly reduced. A cost-benefit analysis, however, revealed that the financial saving from this time reduction was outweighed by the cost of the localization procedures. The authors conclude that investigations for definition of enlarged parathyroid glands are not indicated prior to unilateral parathyroidectomy.

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organization
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Contribution to journal
publication status
published
subject
keywords
Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Humans, Hyperparathyroidism, Middle Aged, Preoperative Care, Radionuclide Imaging, Sensitivity and Specificity, Tomography, X-Ray Computed, Ultrasonography
in
Acta Chirurgica Scandinavica
volume
156
issue
1
pages
7 pages
publisher
Almqvist & Wiksell
external identifiers
  • Scopus:0025055297
ISSN
0001-5482
language
English
LU publication?
yes
id
33844f41-c9ad-4ecd-be77-4fb6213e8880
date added to LUP
2016-08-16 12:18:52
date last changed
2016-10-13 05:12:21
@misc{33844f41-c9ad-4ecd-be77-4fb6213e8880,
  abstract     = {<p>In 50 patients with primary hyperparathyroidism, investigation before initial neck exploration included ultrasonography, computed tomography and 99technetium-201thallium subtraction scintigraphy. The sensitivity for correct preoperative localization was 50%, 54% and 56%, respectively. There was marked inter-observer variation in assessment of ultrasonography and computed tomography, while scintigrams were evaluated by only one person. The scintigraphic sensitivity increased with size of the glands. In cases where correct preoperative localization permitted unilateral parathyroidectomy, the time for surgery and anesthesia was significantly reduced. A cost-benefit analysis, however, revealed that the financial saving from this time reduction was outweighed by the cost of the localization procedures. The authors conclude that investigations for definition of enlarged parathyroid glands are not indicated prior to unilateral parathyroidectomy.</p>},
  author       = {Udén, P and Aspelin, P and Berglund, J and Lilja, B and Nyman, U and Olsson, L E and Zederfeldt, B},
  issn         = {0001-5482},
  keyword      = {Adult,Aged,Aged, 80 and over,Cost-Benefit Analysis,Humans,Hyperparathyroidism,Middle Aged,Preoperative Care,Radionuclide Imaging,Sensitivity and Specificity,Tomography, X-Ray Computed,Ultrasonography},
  language     = {eng},
  number       = {1},
  pages        = {29--35},
  publisher    = {ARRAY(0xb3628a8)},
  series       = {Acta Chirurgica Scandinavica},
  title        = {Preoperative localization in unilateral parathyroid surgery. A cost-benefit study on ultrasound, computed tomography and scintigraphy},
  volume       = {156},
  year         = {1990},
}